Mental health legislation Flashcards
involuntary treatment for mental illness?
Treatment of a small group of patients, those who are:
1 - severely unwell, psychotic
2 - Risk to self or others
Mental heath legislation provides a
legal mechanism to authorise treatment for patients that would otherwise fall into other categories
Involuntary treatment - general criticisms?
ill-liberal
May not be compatible with the international rights
unnecessary for most patients
practical problems in administering
Name some international right acts (4)
European convention on human rights, Scotland Act, Human rights act, Universal declaration of human rights (UN), Convention on the rights of persons with disabilities
Involuntary treatment - ethical criticisms (4)
non-maleficence
autonomy (liberty)
paternalism - ignores patients views
Non-discrimination (physical vs mental illness)
Involuntary treatment - ethical justifications (4)
Beneficence (including reducing risk)
Autonomy (may promote reasoned autonomy)
Right to treatment
Paternalism
Mental health act in scotland
Mental health (care and treatment Scotland) - 2003 modified in 2015
Why do we have mental health law
power to provide compulsory care and treatment for those with disorder
- rights and safeguards to ensure powers are used correctly
- wide range of services for people with mental health disorder
What legislation can also be used for someones liberty and involuntary treatment
Public health Act
Mental health care and treatment Scotland act - main principles
- non discrimination
- Equality
- respect for diversity
- Reciprocity
- informal care
- participation
- respect for carers
- benefit
- child welfare
- least restrictive alternative
Mental disorder is defined as
any mental illness, personality disorder, learning difficulty however caused or manifested
Don’t have a mental disorder based on these factors alone
Sexual orientation or deviancy
transsexulism, transvestism,
dependent on alcohol or drugs
behaviour that causes harassment, alarm or distress to another person
Name some important legislation acts (5)
Children (scotland act) 1995 criminal procedure act 1995 The human rights act 1998 Adults with incapacity act 2000 Adult support and protection 2007
MH (C&T) (S) act - powers in it, whats it determined by?
civil
can detain, assess and treat
approved med practitioner, mental health officer, court
Who can be detained?
anybody
if under 18 - need child specialist
Main pieces of legislation that would be looked at? (4)
emergency detention certificate (EDC)
short-term detention certificate (STDC)
compulsory treatment disorder (CTO)
nurses holding power
The EDC - describe
up to 72 hours transfer to a psychiatric hospital - FULLY registered practitioner - no right to appeal for the patient - likely the patient has a MD, risk to self or others - assessment and emergency treatment
The (STDC) - describe
28 days must be an AMP - within 24 hours MHO The named person is consulted Assessment and treatment PATIENT CAN APPEAL
Criteria for STDC? (5)
- patient has MD
- ability to make decisions is impaired as a result of MD
- A significant risk to health, safety and welfare of patient or another person if they were not detained in hospital
- need to be in hospital to determine treatment
- certificate is necessary
Compulsory treatment order - features
up to 6 months for first one - application by a MHO to the MHTS Two medical reports - GP AND AMP - proposed care plan - criteria the same as STDC - COMMUNITY or HOSPITAL
What is SIDMA
significant impairment of decision making ability about medical treatment for medical disorder - CAPACITY TEST
Features of SIDMA (5)
lack of insight Cog impairment presence of psychosis severe depressive symptoms learning disability
what body considers applications and appeals around the mental health act
mental health tribunal
police powers under act (2)
removal
detain and asssess
Adults with incapacity act 2000 - what does incapable mean (5)
of action, making decisions, communicating decisions, understanding decisions or retaining the memory of decisions
Capacity is assumed to be present unless? it is…
proven otherwise
situation specific
Principles of the AWIA?
take in past and present wishes of patient - account taken of relatives/carers/attorneys
- intervention must benefit the adult
- leant restriction in relation to their freedom as possible
What do we do to assess capacity ? (5) - gather info
- evidence from court or case record
- carers or fam members to give history
- do they have power of attorney
- any previous assessments
- any prev stated views
What do we do to assess capacity - clinical assessment
CURD
communication, understanding, retention of info, decision
clinical assessment - communication (7)
can they communicate? sign language hearing aids written communication Makaton Braille Speech and language therapy assessment
clinical assessment - understanding (4)
adequate info
pros and cons
ability to weigh the evidence
discussed the important risks
clinical assessment - retention (2)
what did i want you to do?
can you explain it to me?
clinical assessment - decision (2)
is it clear what the decision is
is it consistent
Areas of the incapacity act? (3)
Property
Welfare
Financial
Powers of the incapacity act?
intervention order - one off - application to court
guardianship order - doctors, MHO,
the incapacity act does not authorise?
- the use or force or detention - unless immediately necessary
- action that would be inconsistent by a court
- placing an adult in hospital for treatment against their will
Adult protection deals with
harm inflicted by others, self harm and neglect
What is the 3 point test of an adult that is at risk
- unable to safeguard their own well-being, property rights or other harm
- at risk of harm
- affected by disability, mental disorder, illness or physical mental wellbeing
Adult protection - what is risk defined as
another persons conduct is likely to cause the adult harm
- the adult is engaging in conduct that is likely to cause self harm
Adult protection - what is harm defined as (4)
conduct which causes:
physical harms, psychological harms, unlawful conduct, self harm
What do you do if you suspect an adult at risk?
speak to a senior
document concerns
report to relevant local authority
